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General NPI Number Information
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NPI Number | 1811244726
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE HEALTHCARE MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 695 W FLEMING DR
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City | MORGANTON
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State | NC
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Zip | 28655-4450
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Country | US
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Telephone | 828-580-3278
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Fax | 828-580-3279
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Provider Business Mailing Address
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Address Line | 695 W FLEMING DR
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City | MORGANTON
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State | NC
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Zip | 28655-4450
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Country | US
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Telephone | 828-580-3278
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Fax | 828-580-3279
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Authorized Official
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Title or Position | SVP-CFO
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Name | PATRICIA MOLL
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Credential |
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Telephone | 828-580-5003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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